Health policies and data

Primary Care in Denmark

In many ways, primary care in Denmark performs well. Danish primary care is trusted
and valued by patients, and is relatively inexpensive. But there are important areas
where it needs to be strengthened. Most critically, Danish primary care is relatively
opaque in terms of the performance data available at local level. Greater transparency
is vital in the next phase of reform and sector strengthening. Robust information
on quality and outcomes empowers patients and gives them choice. It can support GPs
to benchmark themselves, and engage in continuous quality improvement. It also allows
the authorities to better understand where they should direct additional resources.
This report draws on evidence and best practice from across OECD health systems to
support Denmark in: agreeing on the steps that will strengthen its primary care sector,
delivering high-quality, patient-centred care, and establishing a sustainable footing
as the foundation for a high-performing health system.

Primary care is well-established at the heart of the Danish health care system. Danes rate the care given by their GP highly, with 91% giving a positive assessment compared to a European Union average of 84%

But high-quality primary care is not always delivered. Rates of avoidable hospitalisation for people with chronic bronchitis or diabetes are higher in Denmark than in Sweden or Norway, and avoidable admissions for people aged over 65 vary two-fold across Danish municipalities

More broadly, the Danish health care system is evolving rapidly. After a heart attack, Danes spend just under four days in hospital – the fastest discharge time in the OECD – underlining the need for high-quality primary care across the country

Better data is key to improving performance. But DAMD, the national information system that used to monitor primary care health care needs, activities and patient outcomes, collapsed in 2014. Denmark is now one of the few countries in the OECD with no means of monitoring primary care performance. Patients also lost the ability to ability to access their care records – critical to those living with long-term conditions like diabetes

Payment systems also need reform, to better reward the quality of care. The fee-for-service model dominates in Danish primary care – rewarding activity, not outcomes. There is also substantial scope to develop the role of primary care nurses, and to develop more effective collaboration between GPs and municipalities at local level

DATA

Influenza vaccination for people aged over 65 has increased rapidly in Denmark, but still falls short of rates achieved in other countries